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From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21):2003-2011. doi:10.1001/jama.282.21.2003.

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Presentation on theme: "From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21):2003-2011. doi:10.1001/jama.282.21.2003."— Presentation transcript:

1 From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21): doi: /jama Figure Legend: Computed tomographic scans (A-C) and angiography (D-F) in an 80-year-oldman with acute left hemiparesis. A, Baseline CT scan shows a suggestion ofvery early edema in the posterior aspect of the right putamen and insularcortex (arrow). B, Follow-up CT at 24 hours shows a small amount of edemain the posterior putamen only. C, By 8 days this has evolved to a small petechialhemorrhagic infarction. D, Angiography (frontal view, right carotid arteryinjection) confirms a proximal right M1 occlusion (arrow). E, Amicrocatheter is introduced (arrowheads), and clot is confirmed by hand contrastinjection (arrow). Recombinant prourokinase infusion was begun via microcatheter4.8 hours after symptom onset. F, After 120 minutes, carotid artery injectionshows complete clot lysis with normal distal flow. Date of download: 10/14/2017

2 From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21): doi: /jama Figure Legend: Stroke patients were screened over a 30-month period resulting inexclusion based on protocol criteria: clinical exclusion (83%), computed tomographic(CT) scan exclusion (8%), other exclusions (6%), and cerebral angiographyexclusions (3%). Screening resulted in a randomized patient population of180 (2% of screened patients). Asterisk indicates number of exclusion reasons;because subjects could have multiple reasons for exclusion, number of reasonsis greater than total number of patients screened. NIHSS indicates NationalInstitutes of Health Stroke Scale; r-proUK, recombinant prourokinase; andMCA, middle cerebral artery. Date of download: 10/14/2017

3 From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21): doi: /jama Figure Legend: A score of ≤2 (yellow) on the modified Rankin scale (mRS) indicatesa favorable outcome of slight or no disability. A score of 6 represents death.r-proUK indicates recombinant prourokinase. Date of download: 10/14/2017

4 From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21): doi: /jama Figure Legend: Data are based on adjudicated results by an external safety committeeblinded to treatment and clinical outcome. Neurological deterioration wasdefined as a 4-point or more increase on the total National Institutes ofHealth Stroke Scale (NIHSS) score or a 1-point increase in level of consciousnesson the NIHSS. Timepoints were based on the onset of symptoms relative to theinitiation of randomized therapy. r-proUK indicates recombinant prourokinase. Date of download: 10/14/2017

5 From: Intra-arterial Prourokinase for Acute Ischemic StrokeThe PROACT II Study: A Randomized Controlled Trial JAMA. 1999;282(21): doi: /jama Figure Legend: Determination of 2-hour recanalization was made by a neuroradiologistat a core facility who was blinded to treatment and clinical outcome. One-hourrecanalization was determined unblinded by the neuroradiologist. TIMI indicatesThrombolysis in Myocardial Infarction trial. TIMI 2 is partial flow in themiddle cerebral artery; TIMI 3 is complete flow in both the M1and M2 segments of the middle cerebral artery. Date of download: 10/14/2017


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